Sunday, November 25, 2007

Spinal Cord Stimulation as a Possible Weight Loss Option

As the world looks for more ways to tackle the obesity and overweight problems, new approaches to weight loss are always being investigated. Spinal Cord Stimulation (SCS), which is used for pain relief, is now being investigated as a treatment for weight loss.

In a study reviewing SCS results where two overweight women received 50% back and leg pain relief, the two women also lost approximately 20 pounds, despite no change in exercise. So using SCS to treat weight loss may be feasible.

Indeed, the treatment may be an important tool in the overall fight against our obesity and overweight problems. Therefore, bariatric or weight loss centers should consider SCS as a possible, future addition to weight loss services.

Of course, more research on SCS treatment needs to be done, but the strategic managers and clinicians within a bariatric or weight loss center should pay close attention to studies associated with the use of spinal cord stimulation for weight loss. And if and when the treatment seems reasonable, SCS should be added as a weight loss service.

Monday, November 19, 2007

Offering Weight Loss Medications May Be a Good Strategic Move for a Weight Loss or Bariatric Center

There have been a number of weight loss medications in the news over the past years. And recently, researchers in Brazil and Canada found that three weight loss medications, Roche Holding AG's Xenical, Abbott Laboratories' Meridia, and Sanofi-Aventis S.A.'s Acomplia, can help a person lose from about six-to-ten pounds. But these medications carry some serious associated side effects.

However, despite the side effects, a six-to-ten pound weight loss can sometimes improve a person's health. For example, persons who used Xenical had decreased cholesterol and blood pressure readings, and lower incidents of diabetes. However, about 30% of the Xenical users also experienced side effects, including incontinence.

Persons using Meridia saw reductions in cholesterol numbers, but 20% experienced side effects including higher blood pressure and pulse rates. The Acomplia users saw lower blood pressures and cholesterol levels. However, about 6% of the Acomplia users suffered from mood disorders.

Meridia and Xenical are available in the U.S. And Alli, an over the counter, lower-dose form of Xenical, is now also available in the U.S.

Although the use of these medications can carry side effects, as indicated above, their use can help some persons lose weight. And the use of these medications may lower blood pressure and cholesterol levels, and reduce the number of diabetes cases.

So bariatric or weight loss centers, that don't include the use of these medications in their arsenal of weight loss tools, might want to consider the use of these medications for those persons who want or need to lose from six-to-ten pounds.

Of course the medical experts in a bariatric or weight loss center would have to decide if the use of weight loss medications is a good idea. These experts would need to review the benefits and the possible side effects associated with the use of these medications, then decide. However, offering these medications to appropriate customers could be a smart strategic move.


Friday, November 16, 2007

The da Vinci Robotic Surgical System Can Improve The Quality of Bariatric Surgery

Often times in the healthcare industry, the use of new technology increases the costs of healthcare without improving the quality. For example, an October, 2007 Consumer Reports study showed that new technology that uses CT scans to perform full body screens, at an average cost of $1000.00, does not offer the patient any proven benefit. And the CT scans may be detrimental because of the associated radiation.

In another example from the study, even after using a $450.00 CT scan to perform angiography to locate narrowing or blockage in coronary arteries, standard angiography, where a catheter is inserted into an artery, is sometimes needed to confirm blockage.

So using new -- and in many cases -- expensive medical technology may not necessarily add to the quality of the healthcare. However, we believe that the da Vinci Robotic System, which is designed to enhance a surgeon’s accuracy during minimally invasive surgery, can add quality to bariatric surgery -- especially gastric bypass surgery.

The da Vinci gastric bypass surgery offers the potential benefits of lowering hospital stays, reducing complications and improving outcomes. These three items are important indicators of quality.

We believe that the da Vinci Robotic System gives a bariatric center a competitive advantage. Northwest Hospital & Medical Center, in Seattle, recently added the da Vinci System to its surgical technologies. We believe that this was a smart strategic move. In addition to using the advanced technology, the center is making sure that the public is made aware of the center's use of the technology. It is doing so through its web site and in at least one press release.

These are prudent marketing moves. We believe that for any bariatric center that wants to improve or maintain the quality of its bariatric surgery, the da Vinci Robotic System should be part of the center’s surgical technologies, since the system has the potential to be a quality enhancer. And those involved in a bariatric or weight loss surgical center's strategic management should understand the da Vinci Robotic System's strategic benefits.


Sunday, November 11, 2007

A Low Weight Loss Surgery Complication Rate Can Benefit the Bottom Line

One issue that has plagued bariatric surgery has been the associated complications. After the surgery, some patients experience vomiting, vitamin and mineral deficiencies, nausea, infection, bleeding and other problems.

Complications add to the cost of the surgery. For example, a complication-free surgery may cost about $30,000. With complications, that cost could more than double. In some cases with complications, the costs could go even higher. So keeping the bariatric surgery complication rate low is a way to contain the associated bariatric surgery costs.

A July, 2006 New York Times article reported that bariatric surgery complication rates were as high as 40 percent. But today, bariatric surgery related complications appear to be less frequent and less severe than in the past.

Indeed, according to an October, 2007 study whose results were mentioned in MedLine Plus, the complication rate associated with gastric bypass surgery, the most popular form of bariatric surgery, is approximately twenty five percent. And severe complications were experienced in only one percent of the surgeries.

To achieve these low complication rates, the team performing the operation should be experienced, candidates for the surgery have to be selected carefully, and experts in multiple areas -- including nutrition, psychiatry, rehabilitation and exercise -- must be part of the team providing care to the patient.

Maintaining a low complication rate is important to a weight loss or bariatric surgical center. A reputation for low complications can be important to the center's bottom line. Those involved in strategic management (users of environmental scanning, and other competitive intelligence tools) should urge the center's management to insure that the necessary equipment and personnel are in place to reduce or maintain low bariatric or weight loss surgical complications.


Wednesday, November 7, 2007

Cosmetic Surgery As a Surgical Service After Weight Loss or Bariatric Surgery

As the need for weight loss or bariatric surgery increases, some of those who have had the surgery will desire cosmetic surgery to remove excess skin. For example, according to the Corpus Christi Caller-Times, one bariatric surgeon indicated that at least ten percent of his weight loss patients get cosmetic surgery after bariatric surgery.

The cosmetic surgery performed to remove excess skin is sometimes referred to as body contouring plastic surgery. Examples of those who need this type of surgery are shown here. We believe that weight loss or bariatric centers should consider offering body contouring plastic surgery to those persons who desire the surgery after having lost a large amount of weight.

We believe that offering the plastic surgery service should be a possible strategic objective for most bariatric centers. And we believe that bariatric or weight loss managers involved in strategic management should examine this plastic surgery to determine if the surgery is a viable service option. Offering body contouring plastic surgery could give a bariatric or weight loss center a competitive advantage.


Tuesday, November 6, 2007

The Weight Loss or Bariatric Surgical Industry Is Taking the Lead In Responding to Normal Market Forces

Because some persons believe that you can’t judge the quality of a healthcare provider’s services, these persons also believe that the U.S. healthcare industry does not lend itself to market forces. Therefore, unlike in other industries where the consumer can make informed buying decisions, these persons conclude that consumers will never be able to make healthcare purchasing choices based on quality and cost.

However, we believe that using measurements of provider experience, including measurements of mortality rates, treatment outcomes, medical errors, and other patient related data, it is possible to measure quality. Making the appropriate information available to the consumer can help the consumer make important healthcare decisions.

For some healthcare areas, this type of information is already available to the consumer. And by using this information, a consumer can decide which is the best provider for some treatments. In the future, we believe that quality information will be available to the consumer for most treatment areas.

Studies have shown that experience counts when it comes to the quality of the healthcare a consumer receives. The more often a provider performs a procedure, the less often that provider is likely to commit errors. The provider is also less likely to create conditions that will subject the patient to complications associated with a procedure.

For example, a recent New York Times article indicated that "Doctors who have performed more than 250 surgeries to remove a cancerous prostate were more successful ..." And we believe that hospitals, whose teams have performed a certain procedure many times, improve the chances of positive outcomes for the patient. Further, we believe that establishing standards based on experience is the way to improve the quality of healthcare services.

The bariatric surgical industry is one of the leaders in this area. The American Society of Metabolic and Bariatric Surgery (ASMBS) and the American College of Surgeons have established standards for bariatric surgical centers. When a Bariatric Surgical Center satisfies surgical standards established by the ASMBS, that center is inducted into the ASMBS Center of Excellence program. And when a bariatric center satisfies the standards established by the ACS, that bariatric center is inducted into the ACS Center of Excellence program.

To highlight the importance of these programs, in 2006, these two Center of Excellence programs were endorsed by the U.S. government's Centers for Medicare and Medicaid Services (CMS). CMS will only consider paying for bariatric surgery if a bariatric surgical provider is listed in one of these two Center of Excellence programs.

Using the Center of Excellence lists, a consumer can review the providers that have attained the experience needed to perform a quality bariatric surgery. And using cost (and quality) information provided by organizations such as Healthgrades, an organization that gives the consumer access to information on healthcare quality and cost, a consumer needing bariatric surgery can make quality and cost decisions related to the surgery.

Finally, we believe that the existence of standards for bariatric centers is important to anyone in bariatric strategic management. These standards which may lead to a Center of Excellence designation should be part of a bariatric center's strategic plan.

And as a strategic manager extracts competitive intelligence from environmental information exposing competitor approaches to Center of Excellence standards, a strategic manager can help his or her bariatric center CEO better focus the bariatric center's business activities.

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